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General NPI Number Information
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NPI Number | 1144509589
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Entity Type | Organization
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Legal Business Name | CHEN NEUROLOGY SERVICES LLC
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Dates
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Enumeration Date | 08/16/2011
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Last Update Date | 08/16/2011
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Provider Practice Location Address
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Address Line | 1321 NW 14TH ST SUITE 607
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City | MIAMI
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State | FL
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Zip | 33125-1673
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Country | US
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Telephone | 917-238-5425
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Fax |
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Provider Business Mailing Address
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Address Line | 333 LAS OLAS WAY UNIT 2408
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City | FORT LAUDERDALE
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State | FL
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Zip | 33301-2388
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Country | US
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Telephone | 917-238-5425
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Fax |
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Authorized Official
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Title or Position | PRESIDENT AND MANAGER
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Name | MR. YANIV CHEN
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Credential |
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Telephone | 917-238-5425
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME106613
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | ME106599
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License Number State | FL
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